Table 2.
Association between patient characteristics and lenalidomide use among Medicare beneficiaries with MDS*
| Overall (n=22,399) | ||||
|---|---|---|---|---|
| Independent Variables | Odds Ratio | lower limit | upper limit | p-value |
|
| ||||
| Age at Diagnosis | ||||
| (66-74) | ||||
| 75-84 | 0.87 | 0.72 | 1.05 | 0.148 |
| 85+ | 0.58 | 0.46 | 0.74 | <.0001 |
| Sex | ||||
| (Male) | ||||
| Female | 0.90 | 0.76 | 1.07 | 0.240 |
| Race | ||||
| (White) | ||||
| Black | 0.91 | 0.62 | 1.34 | 0.638 |
| Hispanic | 1.13 | 0.65 | 1.95 | 0.669 |
| Other | 0.85 | 0.53 | 1.37 | 0.506 |
| Proportion with<high school education | 0.81 | 0.34 | 1.92 | 0.627 |
| % with English language difficulty Median household income (quartile) | 2.19 | 1.39 | 3.46 | 0.001 |
| (1st) | ||||
| 2nd | 1.27 | 1.00 | 1.61 | 0.050 |
| 3rd | 1.11 | 0.85 | 1.45 | 0.442 |
| 4th | 1.05 | 0.79 | 1.41 | 0.726 |
| Urbanicity | ||||
| (Large urban) | ||||
| Other urban/rural | 0.94 | 0.75 | 1.18 | 0.600 |
| Census Region | ||||
| (Midwest) | ||||
| Northeast | 0.90 | 0.69 | 1.16 | 0.407 |
| South | 1.09 | 0.88 | 1.34 | 0.440 |
| West | 0.90 | 0.68 | 1.19 | 0.450 |
| Drug Coverage | ||||
| (Continuous Part D, non-LIS) | ||||
| Continuous Part D, LIS | 0.99 | 0.81 | 1.23 | 0.956 |
| MDS Risk Group | ||||
| Low Risk (238.72) | ||||
| Unspecified (238.7 & 238.75) | 0.73 | 0.60 | 0.89 | 0.002 |
| Del5qMDS (238.74) | 15.36 | 11.80 | 19.98 | <.0001 |
| High Risk (238.73) | 1.70 | 1.26 | 2.29 | 0.001 |
| Disability Status | ||||
| (Good) | ||||
| Poor | 0.56 | 0.41 | 0.75 | <.0001 |
| Comorbidities (past year) | ||||
| Diabetes | 0.83 | 0.69 | 0.99 | 0.043 |
| Thyroid disorder | 1.09 | 0.90 | 1.32 | 0.371 |
| Acute myocardial infarction | 0.63 | 0.35 | 1.15 | 0.130 |
| Congestive heart failure | 1.03 | 0.83 | 1.28 | 0.771 |
| Ischemic heart disease | 1.07 | 0.89 | 1.28 | 0.491 |
| Stroke or transient ischemic attack | 0.68 | 0.51 | 0.91 | 0.009 |
| Cardiac conduction disorder | 0.96 | 0.79 | 1.17 | 0.715 |
| Renal disease | 0.72 | 0.58 | 0.88 | 0.002 |
| Liver disease | 0.69 | 0.45 | 1.07 | 0.101 |
| Venous thromboembolism | 1.42 | 0.98 | 2.06 | 0.068 |
| Gastrointestinal bleed | 1.19 | 0.93 | 1.51 | 0.173 |
| Solid tumor | 1.10 | 0.90 | 1.34 | 0.357 |
| Cytopenia | 0.83 | 0.51 | 1.35 | 0.452 |
| Neutropenia | 1.26 | 0.98 | 1.62 | 0.078 |
| Pancytopenia | 1.56 | 1.21 | 2.02 | 0.001 |
| Thrombocytopenia | 1.26 | 1.03 | 1.54 | 0.026 |
| Diagnosis period | ||||
| (2006-first half) | ||||
| 2006-2nd half | 0.99 | 0.77 | 1.28 | 0.958 |
| 2007-1st half | 0.77 | 0.60 | 1.00 | 0.047 |
| 2007-2nd half | 0.70 | 0.52 | 0.93 | 0.014 |
| 2008-1st half | 0.68 | 0.51 | 0.90 | 0.007 |
| 2008-2nd half | 0.65 | 0.46 | 0.90 | 0.009 |
*
Restricted to Medicare beneficiaries with continuous Part A/B/D coverage excluded beneficiaries who were first dispensed lenalidomide prior to the incident MDS diagnosis in 2006-2008
Source: 100% Medicare enrollment and claims for beneficiaries with MDS, enrolled in Medicare Part D, 2006-2008)